Premera Blue Cross

2024 information | 2023 information

About Premera Blue Cross

Premera Blue Cross has provided health plans to school employees across the state since 1962. Premera is headquartered in Washington State and provides health benefits to 2.8 million people nationwide. Our SEBB plans are designed with school employees in mind and are backed by best-in-class customer service and the Blue Cross Blue Shield Association.

Premera offers three SEBB plans, so you have a range of options. You can choose plans based on where you live or work. Not all plans are offered in all counties, though, so be sure to check what plans are available to you.

All Premera SEBB plans come with:

• 24-hour virtual care
• $0 preventive care
• Behavioral health benefits (in person and virtual)
• Access to high-quality doctors and hospitals, including the largest provider groups in every part of the state

2024 information

Plan details

• Additional plan benefits
• Member brochure

Premera High PPO

The High PPO Plan comes with in-network access to over 1.7 million providers nationwide. Watch a video to learn more about the High PPO plan.

Providers

Premera High PPO uses the Heritage Prime network.

Deductibles

• Medical: $750/person ($1,875 families) for in-network care
• Prescription drug: $125/person ($312 families), waived for generic drugs

Key features of the plan

Best-in-class customer service, 24-hour virtual care, $0 preventive care, no referrals needed for specialty care, 24 annual visits each for massage, chiropractic, acupuncture, and access to 63,000 in-network pharmacies.

Available counties

You can choose this plan if you live or work in one of these counties: Adams, Asotin, Benton, Chelan, Clallam, Columbia, Cowlitz, Ferry, Franklin, Garfield, Grant, King, Kitsap, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, Skagit, Skamania, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Whitman, and Yakima.

Who should consider this plan?

This plan is great for those looking for a lower deductible and predictable office visit copays.

Coverage documentation

• Summary of Benefits and Coverage (SBC)
• Benefits Book
• Plan highlights

Premera HMO

The Premera HMO provides access to the Sherwood Network within Washington and emergency care nationwide. Watch a video to learn more about Premera HMO.

Providers

Premera HMO uses the Sherwood network.

Deductibles

• Medical: $750/person ($1,500 families)
• Prescription drug: none

Key features of the plan

In-network access to over 22,000 healthcare providers, including 28 hospitals, dozens of urgent care, primary care, and specialty care clinics. The growing network includes: EvergreenHealth, MultiCare Health System, Kinwell (primary care clinics), Mary Bridge Children's Hospital, Shriners Hospital for Children, Seattle Children's, and Virginia Mason.

There is no out-of-network coverage except for urgent and emergency care (covered nationwide).

Designated primary care provider of your choice is your main contact for care, referrals required for specialty care and some specialty prescriptions, best-in-class customer service, 24-hour virtual care, $0 preventive care, behavioral health provider finder service, same-day, in-home urgent care, 24 annual visits each for massage, chiropractic, acupuncture, access to 1,300 in-network pharmacies in Washington.

Available counties

You can choose this plan if you live or work in one of these counties: King, Pierce, Spokane, and Thurston.

Who should consider this plan?

This plan is great for those who want the lowest cost monthly premium available and low out-of-pocket costs.

Coverage documentation

• Summary of Benefits and Coverage (SBC)
• Benefits Book
• Plan highlights

Premera Standard PPO

Premera’s Standard PPO Plan comes with in-network access to over 1.7 million unique providers nationwide. Watch a video to learn more about the Standard PPO plan.

Providers

Premera Standard PPO uses the Heritage Prime network.

Deductibles

• Medical: $1,250/person ($3,125 families) for in-network care
• Prescription drug: $250/person ($750 families), waived for generic drugs

Key features of the plan

Best-in-class customer service, 24-hour virtual care, $0 preventive care, no referrals for specialty care, 24 annual visits each for massage, chiropractic, acupuncture, and access to 63,000 in-network pharmacies.

Available counties

You can choose this plan if you live or work in one of these counties: Adams, Asotin, Benton, Chelan, Clallam, Columbia, Cowlitz, Ferry, Franklin, Garfield, Grant, Grays Harbor, Jefferson, King, Kitsap, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Oreille, Pierce, Skagit, Skamania, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Whitman, and Yakima.

Who should consider this plan?

This plan is great for those looking for a lower employee monthly premium and predictable office visit copays.

Coverage documentation

• Summary of Benefits and Coverage (SBC)
• Benefits Book
• Plan highlights

2023 information

Plan details

• Additional plan benefits
• FAQs
• Member brochure

Premera High PPO

The High PPO Plan comes with in-network access to over 1.7 million providers nationwide. Watch a video to learn more about the High PPO plan.

Deductibles

This preferred provider plan has a $750 medical deductible for individuals and $1,875 medical deductible for families when receiving in-network care. The prescription drug deductible is waived for generic drugs and is $125 for individuals and $312 for families.

Key features of the plan

Best-in-class customer service, 24-hour virtual care, $0 preventive care, no referrals needed for specialty care, 24 annual visits for each alternative care specialty: massage, chiropractic, acupuncture, and access to 63,000 in-network pharmacies.

Available counties

You can choose this plan if you live or work in one of these counties: Adams, Asotin, Benton, Chelan, Clallam, Columbia, Cowlitz, Ferry, Franklin, Garfield, Grant, King, Kitsap, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, Skagit, Skamania, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Whitman, and Yakima.

Who should consider this plan?

This plan is great for those looking for a lower deductible and predictable office visit copays.

Coverage documentation

• Summary of Benefits and Coverage (SBC)
• Benefits Book
• Plan highlights

Premera HMO

The Premera HMO provides access to the Sherwood Network within Washington and emergency care nationwide. Watch a video to learn more about Premera HMO.

Deductibles

This preferred provider plan has a $750 medical deductible for individuals and $1,875 medical deductible for families when receiving in-network care. The prescription drug deductible is waived for generic drugs and is $125 for individuals and $312 for families.

Key features of the plan

In-network access to over 13,000 healthcare providers, including 15 hospitals, dozens of urgent care, primary care, and specialty care clinics. The growing network includes: MultiCare Health System, MultiCare Indigo Urgent Care, Kinwell (primary care clinics), MultiCare Rockwood Clinics, Mary Bridge Children's Hospital, and Seattle Children's.

There is no out-of-network coverage except for urgent and emergency care.

Designated primary care provider of your choice is your main contact for care, primary care provider makes referrals to specialty care, best-in-class customer service, 24-hour virtual care, $0 preventive care, behavioral health provider finder service, same-day, in-home urgent care, 24 annual visits for each alternative care specialty: massage, chiropractic, acupuncture, access to 1,300 in-network pharmacies in Washington.

Available counties

You can choose this plan if you live or work in one of these counties: Pierce, Spokane, and Thurston.

Who should consider this plan?

This plan is great for those who want the lowest cost monthly premium available and low out of pocket costs.

Coverage documentation

• Summary of Benefits and Coverage (SBC)
• Benefits Book
• Plan highlights

Premera Standard PPO

Premera’s Standard PPO Plan comes with in-network access to over 1.7 million unique providers nationwide. Watch a video to learn more about the Standard PPO plan.

Deductibles

This preferred provider plan has a $1,250 medical deductible for individuals and $3,125 medical deductible for families when receiving in-network care. The prescription drug deductible is waived for generic drugs and is $250 for individuals and $750 for families.

Key features of the plan

Best-in-class customer service, 24-hour virtual care, $0 preventive care, no referrals for specialty care, 24 annual visits for each alternative care specialty: massage, chiropractic, acupuncture, and access to 63,000 in-network pharmacies.

Available counties

You can choose this plan if you live or work in one of these counties: Adams, Asotin, Benton, Chelan, Clallam, Columbia, Cowlitz, Ferry, Franklin, Garfield, Grant, Grays Harbor, Jefferson, King, Kitsap, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Oreille, Pierce, Skagit, Skamania, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Whitman, and Yakima.

Who should consider this plan?

This plan is great for those looking for a lower employee monthly premium and predictable office visit copays.

Coverage documentation

• Summary of Benefits and Coverage (SBC)
• Benefits Book
• Plan highlights